Use of 1,3-β-D-glucan in invasive fungal diseases in hematology patients

Daniele Roberto Giacobbe, Valerio Del Bono, Claudio Viscoli, Malgorzata Mikulska

Research output: Contribution to journalReview article

Abstract

Introduction: Invasive fungal diseases (IFD) remain a leading cause of morbidity and mortality in hematology patients. Within a diagnostic-driven approach, the use of the serum (1,3)-ß-D-glucan (BDG) test represents a valid tool for the early diagnosis and treatment of IFD. Areas covered: The available literature on the use of BDG in hematology patients was systematically retrieved. Then, it was reviewed and discussed, to identify key issues pertaining to a clinically-oriented narrative presentation of the topic. Expert commentary: The use of BDG in hematology patients at risk for invasive aspergillosis (IA) is secondary to the use of galactomannan. However, since BDG is not specific for IA, it offers an advantage of diagnosing also other IFD, such as candidiasis and pneumocystosis. The limitations of BDG include high costs and lower sensitivity in hematology patients compared to other cohorts. The risk of false positive results is possibly lower in real life than in theory, since glucan-free equipment is available and modern dialysis membranes and blood products usually do not release BDG. Thus, in experienced hands and selected clinical situations, BDG is a useful diagnostic tool, particularly due to short turnover time to results and versatility in diagnosing different IFD.

Original languageEnglish
Pages (from-to)1101-1112
Number of pages12
JournalExpert Review of Anti-Infective Therapy
Volume15
Issue number12
DOIs
Publication statusPublished - Dec 2 2017

Keywords

  • antifungal therapy
  • Biomarker
  • candidemia
  • early diagnosis
  • hematology
  • invasive aspergillosis
  • invasive fungal diseases
  • Pneumocystis jirovecii

ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)
  • Infectious Diseases
  • Virology

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